A currently used method of stabilizing endotracheal (E.T.) tubes is the popular method of taping the tube to the patient's mouth with surgical adhesive tape. However, this method has many problems, among them:
(1) Taping requires special skill and care, and if it is executed incorrectly the tube can still move in and out of the patient's mouth enough to cause significant irritation of the trachea.
(2) Saliva collects on the tape, and the tape in turn loses its adhesive efficacy, presenting the possibility of tube migration or accidental extubation. This problem also promotes biological contamination.
(3) Periodic replacement of the adhesive tape (due to problem No. 2 above) causes irritation of the patient's skin, especially in those patients requiring long term intubation. Long term intubation is not uncommon in neonatal and pediatric intensive care units.
(4) Any slight adjustments to the tube's position require removal of the tape and then retaping.
(5) Access to the mouth for suctioning etc. is made difficult by the presence of the tape.
There have been many attempts to provide stabilization for endotracheal tubes. Often the prior devices fail to address the problems associated with the taping method in a way that is suitable for neonatal and pediatric applications. That is why the taping method is still so widely used. Some devices, such as those shown in U.S. Pat. Nos. 4,191,180, 4,331,143 and 4,537,192, employ straps which pass behind the head and/or neck. While the use of straps provides more rigid tube support, straps are undesirable on infants whose heads are growing rapidly, especially when long term intubation is involved. Also, the straps can become entangled in the patient's bedsheets. Other devices, such as those shown in U.S. Pat. Nos. 3,993,081 and 3,713,448, are overly complicated to apply, especially when exact positioning of the tube within the tracea is critical, as is the case with small babies. Still other devices, such as what is shown in U.S. Pat. No. 4,329,984, are no better than the taping method, in that they still require taping in the area of the mouth, resulting in restricted access to the mouth and the attendant problems with saliva. Some proposed solutions (patents 4,331,143 and 4,537,192) cover vital areas of the patient's face such as the nose, mouth, and eyes, restricting access. The devices described in patents 4,331,143 and 4,537,192 do not address the means of attachment of the tube to the stabilization device in a credible manner. Mere "frictional restraint" is not a sufficiently reliable means of holding endotracheal tubes in the clinical setting.